<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">

<head>
	<meta http-equiv="Content-type" content="text/html;charset=UTF-8" />
	<title>AmazonLite</title>
	<script type="text/javascript" src="validation.js"></script>
	<link rel="stylesheet" type="text/css" href="common.css" />
</head>

<body>

<h2>Signup</h2>

<form class="large" name="signup" action="signup_success.html" onsubmit="return validateForm()" method="post">
<table>
	<tr>
		<td class="col1">
		Login:
		</td>
		<td>
		<input type="text" name="login" />
		</td>
	</tr>
	<tr>
		<td class="col1">
		First name:
		</td>
		<td>
		<input type="text" name="fname" />
		</td>
	</tr>
	<tr>
		<td class="col1">
		Last name:
		</td>
		<td>
		<input type="text" name="lname" />
		</td>
	</tr>
	<tr>
		<td class="col1">
		Gender:
		</td>
		<td>
		<input type="radio" name="gender" value="male" />Male
		<input type="radio" name="gender" value="female" />Female
		</td>
	</tr>
	<tr>
		<td class="col1">
		Credit card number:
		</td>
		<td>
		<input type="text" name="cc" />
		</td>
	</tr>
	<tr>
		<td class="col1">
		Expiry date:
		</td>
		<td>
		<select name="expiry_month">
			<option value="01" selected="selected">01</option>
			<option value="02">02</option>
			<option value="03">03</option>
			<option value="04">04</option>
			<option value="05">05</option>
			<option value="06">06</option>
			<option value="07">07</option>
			<option value="08">08</option>
			<option value="09">09</option>
			<option value="10">10</option>
			<option value="11">11</option>
			<option value="12">12</option>
		</select>
		<select name="expiry_year">
			<option value="2013" selected="selected">2013</option>
			<option value="2014">2014</option>
			<option value="2015">2015</option>
			<option value="2016">2016</option>
			<option value="2017">2017</option>
			<option value="2018">2018</option>
			<option value="2019">2019</option>
			<option value="2020">2020</option>
		</select>
		</td>
	</tr>
	<tr>
		<td class="col1">
		Address:
		</td>
		<td>
		<input type="text" name="address" />
		</td>
	</tr>
	<tr>
		<td class="col1">
		Password:
		</td>
		<td>
		<input type="password" name="pwd" />
		</td>
	</tr>
	<tr>
		<td class="col1">
		Confirm password:
		</td>
		<td>
		<input type="password" name="conf_pwd" />
		</td>
	</tr>
	<tr>
		<td class="col1">
		Email:
		</td>
		<td>
		<input type="text" name="email" />
		</td>
	</tr>
	<tr>
		<td>

		</td>
		<td>
		<input type="submit" name="submit" />
		&nbsp;
		<input type="reset" name="reset" />
		</td>
	</tr>
</table>
</form>
</body>

</html>
